Anthem Cost Relief

Cost Relief Helping members get to a $0 copay for specialty drugs Specialty drugs offer innovative therapies in addition to With Cost Relief: traditional medicines for a variety of health conditions — but they often come at a high cost. We have a solution to keep y Members pay $0 copay for virtually 1, 2 those costs as low as low as possible. This program could result all specialty drugs. in $0 copays on certain specialty drugs for members. y Employers realize up to $8 per member per month (PMPM) net savings on their total specialty 3 pharmacy drug spend. How Cost Relief works to save money With Cost Relief, members can access available manufacturer copay assistance program funds. This allows us to reduce the plan paid portion for certain specialty drugs. Prior to the program effective date, we reach out to eligible members through a letter, phone calls, and emails to educate them on Cost Relief. This includes explaining what help is available to them in their own copay assistance program. We also make sure they know how to enroll and stay enrolled in the program. y Virtually all specialty drugs are included as part of this program. y Employers can also access the program’s robust reporting and analytics, including use and outreach metrics. Plan exclusions: Federal Employee Program (FEP), group retiree plans, No Bill/No Remit, or health reimbursement account (HRA) with provider pay and point-of-sale (POS) rebates Learn more about how we’re putting the bene昀椀ts back into pharmacy For more information about Cost Relief or to request an opportunity and savings analysis, please contact your plan representative. We’re here to help. 1 Members must enroll in the program and cost share could vary depending on member enrollment. Members who do not wish to participate in this program can opt out and will be responsible for the full amount of the cost share for their specialty drug. Members who have a high-deductible health plan with a health savings account are required to meet their deductible before they can receive a $0 copay. Client should consult legal advisor in considering this benefit feature. 2 Certain Cost Relief Drugs are not classified as “Essential” under the Program and in accordance with the Affordable Care Act. Claims for these Cost Relief drugs would not be subject to a members out of pocket limit. These claims will continue to apply a coinsurance even after the out of pocket is met. 3 Net savings after fees. CarelonRx internal data, 2022. Anthem Blue Cross and Blue Shield is the trade name of: In Colorado: Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc. In Connecticut: Anthem Health Plans, Inc. In Indiana: Anthem Insurance Companies, Inc. In Georgia: Blue Cross Blue Shield Healthcare Plan of Georgia, Inc. and Community Care Health Plan of Georgia, Inc. In Kentucky: Anthem Health Plans of Kentucky, Inc. In Maine: Anthem Health Plans of Maine, Inc. In Missouri (excluding 30 counties in the Kansas City area): RightCHOICE® Managed Care, Inc. (RIT), Healthy Alliance® Life Insurance Company (HALIC), and HMO Missouri, Inc. RIT and certain affiliates administer non-HMO benefits underwritten by HALIC and HMO benefits underwritten by HMO Missouri, Inc. RIT and certain affiliates only provide administrative services for self-funded plans and do not underwrite benefits. In Nevada: Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc., dba HMO Nevada. In New Hampshire: Anthem Health Plans of New Hampshire, Inc. HMO plans are administered by Anthem Health Plans of New Hampshire, Inc. and underwritten by Matthew Thornton Health Plan, Inc. In 17 southeastern counties of New York: Anthem HealthChoice Assurance, Inc., and Anthem HealthChoice HMO, Inc. In these same counties Anthem Blue Cross and Blue Shield HP is the trade name of Anthem HP, LLC. In Ohio: Community Insurance Company. In Virginia: Anthem Health Plans of Virginia, Inc. trades as Anthem Blue Cross and Blue Shield, and its affiliate HealthKeepers, Inc. trades as Anthem HealthKeepers providing HMO coverage, and their service area is all of Virginia except for the City of Fairfax, the Town of Vienna, and the area east of State Route 123. In Wisconsin: Blue Cross Blue Shield of Wisconsin (BCBSWI) underwrites or administers PPO and indemnity policies and underwrites the out-of-network benefits in POS policies offered by Compcare Health Services Insurance Corporation (Compcare) or Wisconsin Collaborative Insurance Corporation (WCIC). Compcare underwrites or administers HMO or POS policies; WCIC underwrites or administers Well Priority HMO or POS policies. Independent licensees of the Blue Cross and Blue Shield Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc.. 1040715CAEENABS 07 23